title: Sleep Disturbances and Risk of Depression in Older Men.
abstract: BACKGROUND
  Self-reported sleep disturbances are associated with an increased risk of depression in younger and older adults, but associations between objective assessments of sleep/wake disturbances via wrist actigraphy and risk of depression are unknown.
  
  
  METHODS
  Depressive symptoms (Geriatric Depression Scale [GDS]), self-reported (questionnaires), and objective (actigraphy) sleep parameters were measured at baseline in 2,510 nondepressed men 67 y or older. Depressive symptoms were reassessed an average of 3.4 ± 0.5 y later.
  
  
  RESULTS
  Of the 2,510 men without evidence of depression at baseline, 116 (4.6%) were depressed (GDS ≥ 6) at the follow-up examination. After adjusting for multiple potential confounders, including baseline depressive symptoms (GDS 0-5), there was evidence of an association between poor self-reported sleep quality and higher odds of being depressed at follow-up (multivariable odds ratio [MOR] = 1.53, 95% confidence interval (CI) 1.00-2.33). In age- and site-adjusted models, objectively measured reduced sleep efficiency (odds ratio [OR] = 1.88, 95% CI 1.13-3.13), prolonged sleep latency (OR = 1.77, 95% CI 1.04-3.00), greater nighttime wakefulness (OR = 1.48, 95% CI 1.01-2.18) and multiple long-wake episodes (OR = 1.69, 95% CI 1.15-2.47) were associated with increased odds of depression at follow-up, but these associations were attenuated and no longer significant after further adjustment for number of depressive symptoms at baseline. Self-reported excessive daytime sleepiness and objectively measured total sleep time were not associated with depression status at follow-up. Excluding baseline antidepressant users from the analyses did not alter the results.
  
  
  CONCLUSIONS
  Among nondepressed older men, poor self-reported sleep quality was associated with increased odds of depression several years later. Associations between objectively measured sleep disturbances (e.g., reduced sleep efficiency, prolonged sleep latency, greater nighttime wakefulness, and greater long-wake episodes) and depression several years later were largely explained by a greater burden of depressive symptoms at baseline.
  
  
  BACKGROUND
  Paudel M; Taylor BC; Ancoli-Israel S; Blackwell T; Maglione JE; Stone K; Redline S; Ensrud KE; for the Osteoporotic Fractures in Men Study Group. Sleep disturbances and risk of depression in older men.SLEEP2013;36(7):1033-1040.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: Misti
authors.initials: M
authors.lastname: Paudel
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Terri
authors.initials: T
authors.lastname: Blackwell
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Maglione
authors.forename: Katie
authors.initials: K
authors.lastname: Stone
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
keywords: Actigraphy; depression; elderly; sleep quality